Negative pressure wound therapy (NPWT) is a wound
treatment involving the application of sub-atmospheric
pressure to remove excessive exudate and prevent infection
while changing dressings and promoting healing (1–4). Since
its development in the 1980s, there have been a number
of research studies supporting the effectiveness of NPWT
in wound healing (5–7). Furthermore, the treatment is
considered to have economic benefits because faster healing
tends to result in a reduced frequency of dressing changes
and lower hospital costs (8,9).
Despite the research support for its effectiveness in wound
healing, fewer studies have considered the impact of NPWT
on the patient in terms of the pain that can be experienced.
Wound care and dressing changes can be very painful for
patients (10), and this pain can also cause patients to feel
stressed or anxious, (11,12) thus impacting negatively on
both their physical and psychological well-being. Such factors
need to be considered in any evaluation of NPWT or other
treatment.
In addition to the effects on patient’s well-being, pain has
also been associated with healing time, with high levels of
pain being linked to delayed healing (13). Stress has also been
linked with healing time (14), so it is possible that painful
dressing changes could prolong treatment because of both
the pain and stress that patients experience, although further
research is needed to confirm theories of how pain and stress
during dressing change may impact on wound healing.
Key Messages
• during NPWT, patients may experience pain and skin
trauma, both of which can affect patient’s well-being
and wound healing
• a literature review was carried out to explore the
research on pain and trauma in NPWT
• studies show that pain during NPWT varies and that
there are certain treatment factors that may affect the
level of pain experienced, such as dressing type and
NPWT system. Such factors are also important in the
occurrence of trauma to surrounding tissue
• there is a need for research to identify which factors
may affect pain and trauma during the different stages
of NPWT